“The whole dissident idea attracts a lot of crazies. And then all of a sudden, without realizing it, you've become one of them." Peter Duesberg, 2009

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Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy

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Tuesday, May 26, 2009

Denying AIDS - A book by Seth KalichmanPosted on: May 26, 2009 6:56 AM, by Mark Hoofnagle at denialism.blog

Seth Kalichman is a better man than me. Kalichman is a clinical psychologist, editor of the journal Aids and Behavior and director of the Southeast HIV/AIDS Research and Evaluation (SHARE) project, and he has devoted his life to the treatment and prevention of HIV. Despite a clear passion for reducing the harm done by HIV/AIDS, to research this book he actually met, and interviewed, prominent HIV/AIDS denialists. I confess I simply lack the temperament to have done this. To this day, when I read about HIV/AIDS denialists, and the the 330,000 people who have died as a result of HIV/AIDS denialism, I see red. I think violent, bloody thoughts.

The HIV/AIDS denialists, like Celia Farber, object to being called denialist, a quote from her in the book:

Those who wish to engage the AIDS research establishment in the sort of causality debate that is carried on in most other branches of scientific endeavor are tarred as AIDS "denialists," as if skepticism about the pathogenicity of a retrovirus were the moral equivalent of denying the Nazis slaughtered 6 million Jews.

To this I would reply that the HIV/AIDS denialists like Duesberg are worse than holocaust deniers. Holocaust deniers are anti-semitic bigots and horrible people sure, but the HIV/AIDS denialists are responsible for an ongoing campaign of death. Because people like Duesberg have convinced morons like Thabo Mbeki of their pseudoscience, hundreds of thousands of people are dead.

This is why I see red. Denialist is about the nicest thing you could call the likes of Farber and Duesberg.

Kalichman's book is well-written, timely, thoroughly researched, and to his great credit he uses my definition of denialism. Ha! How could I help but love this book? The fact that he pursues denialism from a psychological angle, and interacts directly with the critical denialists behind this story make it a profoundly important study and resource in understanding not just HIV/AIDS denialism, but all forms of denialist pseudoscience. This takes a very patient, very dedicated person. I would have lost my temper, lost my patience, or lost my mind to have delved so deep into this madness. Not to mention, I'm not very forgiving or nice to people I perceive as being so detrimental. It's a personality flaw, I recognize it. That's why we're lucky to have people like Seth Kalichman.

Let's discuss some of Kalichman's findings below the fold...

First off, in his introduction he describes what it was like interacting with denialists:

My relationships with denialists created some complicated arrangements that allowed me to experience denialism face-to-face. I often felt more like a journalist than a scientist, giving me a glimpse of how it must feel when denialist journalists delve into science. Still, it is important to say that the denialists who interacted with me did not seem evil. They are deeply skeptical of science and untrusting of government and big business. Some are surely misguided and others seem to foolishly believe that they understand everything there was to know about AIDS. But I did not find them evil in the sense they were intesnt on harming people, even though their actions surely are. Of course, those I have come to see as malevolent - the vitamin pushers con men, and angry academics are the ones who did not respond to my attempts to contact them.

Fascinating. I would be surprised if Kalichman had found them to be overtly sinister, like some disease-denying caricatures reminiscent of Mr. Burns on the Simpsons. I think in light of this description we must remember the phrase the banality of evil used by Hannah Arendt to describe Eichmann. Evil isn't always blocking out the son or stealing candy from infants, or always performed by the sociopaths and madmen of history. Sometimes evil is perpetrated by those who are operating without ill intent within a framework that is twisted and wrong, and this is one of the most important lessons of history. Ordinary people who are perfectly normal are capable of doing great harm under the authority of those with radical ideology. See also the Milgram experiment or the Stanford Prison Experiment as examples of this phenomenon. To find them ordinary, if anything, is what one would expect of foolish people who have adopted the warped and devastating ideology of the HIV/AIDS denialists. This does not exonerate them, it merely informs us of the work we need to do to fight against the thoughtless obeisance to ideology which causes so much human misery.

Kalichman starts with a definition of denialism, a description of HIV/AIDS denial and a justification for using the term. And here is my only criticism of the text. I believe that in defining denialism, he does not succinctly describe the critical elements. This is probably a result of my bias towards my own methods of describing the critical elements of denialism. He does cover them all, going into depth in the importance of conspiracy and suspicious personality traits endemic to denialists as a whole. His discussion was of the defining characteristics was of great value though, and I left feeling as though I learned a great deal about the psychological gray zone between simple denial that most people exhibit in the face of hard truth, the ignorant denial of followers, and the more malignant form of denial that is practiced by the leading pseudoscientists. His subsections on "Suspicious Minds" and "Why AIDS, Why Now" I think are truly novel contributions to the discussion of denialism and provide great information as to the motives and sources of denialist arguments.

His second chapter is an extensive discussion on Duesberg. I was also fascinated by his interaction with Duesberg, who not only sounds like he is fundamentally broken mentally, but ignorant of virology. Kalichman writes "Even knowing the complexity of HIV and the barriers it poses to vaccines, Peter Duesberg looked me dead in the eyes and said that failure to achieve and HIV vaccine means that an infectious agent cannot be the cause of AIDS". I immediately smacked my head and thought, does he also deny that the Hepatitis C virus causes Hepatitis despite antibody response? Or that herpes viruses cause a host of chronic infections despite the presence of antibody? Not every virus is easily vaccinated against, that doesn't mean they're non-infectious or can't cause disease. This is a stunningly stupid statement from a virologist. Duesberg is not just an HIV/AIDS denialist, but also denies the role of viruses in cancer, apparently rejecting the mountains of evidence that HPV causes cervical cancer, that any other virus causes cancer, or that cancer can be caused by gene mutation. I would point out again that he seems ignorant of virology despite extensive experience in the field. How about EBV and Burkitt's Lymphoma? There is no other cause of the disease. Or HHV-8 and Kaposi Sarcoma? Duesberg is a classic crank - incompetent and completely unaware of it, and Kalichman lays out his successive use of each of the denialist tactics from conspiracy, to utterly dishonest cherry-picking of data and quote-mining, to logical fallacies. The image emerges of a man who is just contrary, no matter what he refuses to accept any idea that is mainstream, even if it is true. Kalichman spends the rest of the chapter laying out Duesberg's case, which is laughable, and then smashing it, he even alludes to some nice crank magnetism from the cdesign proponentsists, radical libertarians and environmental extremists. Gems include Duesberg's denial that children or sex-workers die of AIDS. The ability of his delusion to protect him from the reality of AIDS is astonishing, and deadly. Somehow, Kalichman's final summary of Duesberg is ultimately too charitable:

Peter Duesberg's legacies will be that he both discovered the first cancer-causing gene and that he brought a sort of legitimacy to a band of sad denialists and wacky pseudoscientists. How one man could be the source of so many lives saved and so many lives lost is the greatest paradox and human tragedy in this whole contorted affair.

Kalichman has to stretch to say positive things about a man who ultimately comes across as a dishonest contrarian, and an insufferable self-aggrandizer. I also would disagree that he has saved any lives for his discovery of src, as it's not as if it would never be discovered if it wasn't for him. It's not like science is art, and only one artist can create some unique work. It's clear that Duesberg has only been a net negative for humanity and science.

Kalichman's description of pseudoscience in chapter 3 is spot on, but I think more or less synonymous with denialism. I believe denialism is the pseudoscientific method, or at least describes its components. He proposes pseudoscience is kind of an applied form of denialism by quasi-experts seeking legitimacy through a more precise mimicry of the trappings of science - fake journals, fake experts, fake peer review etc. I'm not sure one can say they are truly different, but his description of AIDS pseudoscience is great and more extensive debunking of the variety of denialist claims about the existence or non-existence of HIV and AIDS. Many things become clear, especially the tendency of anti-medical pseudoscientists to blame the victim. Almost all of the the denialist theories seem to find a way to make it the victims fault - their lifestyle, their diet, their genetics, etc. which may feed back on their need for control His close examination of their arguments is sometimes grueling for someone with a medical education, I think my forehead has developed a welt from how many times I smacked it. For instance, I hadn't heard about Celia Farber's theory on HIV and infants:

Journalist Celia Farber confuses HIV infection with antibody responses when she states that all babies born to HIV positive mothers are born HIV positive and that all babies born to HIV positive mothers are born HIV positive and that most become negative months later...In this respect Farber is suggesting that all babies born to women with HIV/AIDS have HIV infection.

Facepalm! In humans, there is a IgG transport system across the placenta that delivers maternal antibodies to the infant so that when it is born it enjoys protection from various infections until its own immune system gets its legs under it. This way infants have much of the same acquired immunity as their mothers for the first few months of life. Since the HIV test tests for the presence of antibodies, this gives a false-positive test until the maternal antibodies disappear and, if the infant is positive, they generate their own HIV antibodies. HIV doesn't readily cross the placental barrier, which is why AZT given before labor, not even during the whole pregnancy, is highly protective against transmission of the virus to the child as it is usually infected during birthing. Why are we even arguing with people so ignorant of basic biology? They don't understand human development, they don't understand immunology, they don't understand virology, they don't even understand how an ELISA assay works, but they'll propose their incompetent use of it discredits the work of every HIV/AIDS researcher in the world! It's maddening to hear these cranks assume the mantle of the likes of Galileo and Einstein - minds that may occur maybe once a century - when they are clearly so completely incompetent. The arrogance is astounding.

After icing my forehead...He forgets to mention Michael Fumento as a denialist for his promotion of the myth that heterosexual sex does not transmit HIV. He's a general-use infectious disease promoter who routinely uses the success of public health efforts as proof they're not needed. After all, if disease doesn't get transmitted, why should we think it has anything to do with public health interventions?

In his fourth chapter he summarizes the dominant conspiracy theories, again a thorough job, as well as an excellent sub-chapter on why denialists make people like me so crazy. In the fifth he makes sure not to let Reagan off the hook in a discussion of political elements of HIV/AIDS denialism. And the last chapter deals with the question of how to get people out of denial. Importantly he recognizes the nature of how denialism is spread, starting with a few sources and then expanding outwards through the echo chambers of the internet. There are few original ideas in denialism, and while good ideas come and go, bad ideas last forever. He has some good suggestions of intellectual shortcuts to avoid BS that I'm sure most of my readers are familiar with. He also recognizes the diverse ideological radicalism which contributes to the formation of these ideas. Whether it's anti-medical cranks, environmental cranks, libertarian cranks, they tend to come to the topic of HIV/AIDS with an ideological axe to grind, rather than truly caring for the victims of the disease. Thus I think their moral position deteriorates further, they use the death of millions and ongoing illness and death of innocent men, women and children to further their bigotry against modern medicine, or to promote their toxin paranoia, or their politics.

He also has inspired me to conduct a kind of experiment. Simply put, denialism is an outgrowth of a certain personality type that is dysfunctional. These people with suspicious/paranoid beliefs, a tendency towards conspiracism, and lack of critical reasoning skills are all over the country and all over the world. They interpret events in a predictable manner. I ask the readers to consider world events from this perspective. Let's see if, in the face of a crisis or other major event, we can predict what those with this conspiratorial mindset will come up with as an explanation. I'm curious to see if we can come up with their unique conspiracy theories before they do. Maybe the next time we see something big break in the news if we can successfully conduct this experiment here at denialism blog.

To sum up, this is a well-written engaging book that should serve as a resource for anyone interested in critical thinking, and just as a fascinating story of how things can go awry in the public understanding of science. It's also the best work I've seen so far in evaluating the psychology of the believers causing all the trouble. This is a subject which needs more attention, and I hope to write about it more in the future.

So buy it! All royalties go to the purchase of anti-retrovirals for people in Africa, so you not only help yourself but you help undo some of the damage done by denialists like Duesberg and Mbeki.

Mark Hoofnagle has a MD and PhD in physiology from the University of Virginia, and is now a general surgery resident. His interest in denialism concerns the use of denialist tactics to confuse public understanding of scientific knowledge.

7 comments:

I saw this at the denialismblog site yesterday...and had some fun leaving comments.However, it would be much more fun to post the Henry Bauer blogs here. Bauer seems to have gone off the deep end with his jealousy of the success of your book (and lack of success for his books!) Right now Bauer has GENEROUSLY offered a free, autographed copy of his HIV FAILINGS book if anyone, including you, Kalichman, can prove something you wrote about Bauer in your book. I have actually thrown the gauntlet to SNOUT as it is "statistical proof" that Bauer is calling for, and ironically, SNOUT has already given this proof a few months ago at snoutworld.blogspot.com!Oh, this is fun!Also, if anyone wins the autographed book, please donate it to me. I have something FUN in mind for it!JTD

JTDThe truth is I never visit Bauer’s blog. That would be a huge waste of my time. I did read some of it when he started ranting about me. My favorites were his KKK allusions and his weepy tear jerker story about not being German but rather Austrian. That is like saying he is a scientific explorer and not a pseudo-scientist. Can someone please explain the difference? So Henry Bauer and Adolf Hitler were both Austrian and not German. Talk about Denial!

Bauer must be disappointed about his book. I mean, he has the PROOF that HIV does not cause AIDS. He actually hoped that he would be on the Today Show (seriously), but he was of course censored. Strange that Duesberg himself has never come out and said Bauer has the proof. Why don’t Duesberg and Mullis endorse Henry Bauer? Must be guilt by association.

Snout has more brains in his toenails than Bauer has in his noggin. Snout versus Bauer is definitely not a fair fight! Sort of like Muhammad Ali versus Don Knots.

The psychopathology is more than obvious. Everything about this points to a character disorder. Like its root characteristics paranoia and narcissism, Denialism is egosyntonic. Which is, of course, fascinating because HIV+ AIDS denialists are unable to manage the trauma of their HIV diagnosis. The reality of HIV/AIDS is unfathomable and denialism is a matter of survival. Even mothers like Maggiore and Stokey place their children in harms-way in their desperation to deny their HIV status. Anonymous, is that enough psychobabble for you?

OH NO...I thought I was safe, but according to Clark Baker any mammal can get AIDS:

"Acquired immune deficiency syndrome has existed, as long as, as far as I have read, heard, and investigated, it's been around ever since humans have been around. Certainly any mammal [Yikes that me!] that is required to drink septic water and endure malnutrition or any human who engages in dangerous behaviors...all of those things will cause AIDS" (Robert Scott Bell show)

Damn, I guess I need to take my vitamins and stay out of toilet bowls!

You have your facts on michael fumento wrong, he is not a denialist. Fumento is most famous for writing "The Myth of Heterosexual AIDS", but he never says that AIDS isn't transmitted through heterosexual sex. He says that in the west, AIDS is comparatively rarely spread via heterosexual sex between two people neither of whom are IV drug users or bisexuals. Many people have died because public health officials have said that everyone is more or less equally at risk for getting AIDS, whereas for the most part, AIDS is confined to homosexual men, IV drug users, and their sex partners. Fumento readily admits there are AIDS cases not in the above categories in the United Staets, and that heterosexual sex is the most common transmission mode in Africa.

Read Ben Goldacre and keep up with Bad Science

Don't Get Fooled Again: The Skeptic's Guide to Life by Richard Wilson

AIDS Denialism on Law & Order

If you missed the Law & Order episode 'Retro' on AIDS denialism you will want to see the 2-minute Replay. This episode portrays a woman who denies she has HIV in which she and her infant daughter both die of AIDS. Sound familiar? Click the pic to watch.

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In Denying AIDS, Seth Kalichman provides a fascinating look into the thinking of those who propagate AIDS myths and the negative impact they have on our response to a deadly disease. He shows us how AIDS pseudoscience confuses the public and threatens sound public health policy. Anyone who cares about the global HIV/AIDS pandemic should read this book. Helene D. Gayle, Chair of the 2009 US Presidential Council on AIDS, CEO CARE USA, former Assistant Surgeon GeneralSeth Kalichman brilliantly uses a psychological lens to expose the wacky world that creates and maintains its presence despite the untold numbers of deaths and suffering it has caused. This book is a wake up call to policy makers and scientists, particularly in places most affected by the pandemic, that denialism must be confronted if we want to bring it under control. A must read for those who want to know more about the power and influence of pseudoscience.Michael Merson, Director, Global Health Institute at Duke University and Former Director of the World Health Organization's Global Program on AIDS.

This excellent book examines the detailed history of HIV/AIDS denialism as well as its damaging impact throughout the world. HIV/AIDS denialism and its proponents have created confusion when the clear provision of scientifically accurate communication was most needed.James Curran, Dean of the Rollins School of Public Health at Emory University, Former Director of the CDC HIV/AIDS Division.

Seth Kalichman has superbly captured the contradictions inherent in AIDS denialism. He has deftly uncovered its religious-like fervor, its vociferous proponents and passionate opponents as well as its destructive force when legitimized by the South African President.Salim S. Abdool Karim, Member of the 2000 South African Presidential Panelon AIDS, Professor at University of KwaZulu-Natal, and Director of Centre for the AIDS Programme of Research in South Africa (CAPRISA)

Royalties from Denying AIDS are donated to buy HIV treatments in Africa